Sclerosing lesions of the temporal bone

Abstract

Sclerosis of the mastoid portion of the temporal bone is often seen on radiographs of patients who have or have had chronic otitis media. Occasionally lesions are seen that cause sclerosis of the entire temporal bone. The otolaryngologist must be alert to the fact that these findings may signify important pathology beyond that of chronic otitis media and indeed may be indicative of life threatening problems in adjacent or distant areas. In this paper the differential diagnoses of sclerotic lesions of the temporal bone will be discussed. These include fibrous dysplasia, osteopetrosis, meningioma, ossifying fibroma and metastatic lesions to the temporal bone. Three representative cases with sclerotic temporal bones are presented. The first is a patient with a conductive hearing loss secondary to stenosis of the external auditory canal. He was found to have a fibrous dysplasia of the temporal bone. The second case is an elderly male with a draining ear and a facial nerve paresis. He was found to have adenocarcinoma of the prostate gland metastatic to the temporal bone. The third case is that of a woman with a meningioma who demonstrated a sclerotic temporal bone on routine radiographs of the skull.

Does cochlear implantation and electrical stimulation affect residual hair cells and spiral ganglion neurons?

“…While the implantation of a scala tympani electrode array has been associated with loss of residual hearing (Rizer et al, 1988;Boggess et al, 1989), the development of electrode arrays and surgical techniques designed to minimize insertion trauma have led to the preservation of residual hearing in some patients (Keifer et al, 2005;Adunka et al, 2004;Gantz and Turner, 2003). The lack of significant insertion trauma observed in the present study supports these clinical findings and indicates that long-term preservation of lowfrequency hearing is possible in implant subjects.…”

Predicting the effect of post-implant cochlear fibrosis on residual hearing

“…More recently, the criteria for candidacy have been lowered so that residual hearing becomes an important issue. After cochlear implantation, residual hearing is worsened or destroyed in the majority of the patients (Boggess et al, 1989;Gomaa et al, 2003;Rizer et al, 1988;Rubinstein et al, 1999). Thus, a common component of patient counseling prior to cochlear implantation is warning them that they likely will lose all hearing in the implanted ear and will be unable to use a hearing aid.…”

Preservation of Residual Hearing in Children and Post-Lingually Deafened Adults after Cochlear Implantation: An Initial Study

“…Brimacombe et al [2] reported significant losses of residual hearing in the implanted ear of 50 patients; Rizer [9] noted a loss in 7 reported patients, and Boggess et al [10] in 12 patients. On a more positive note, Hodges et al [7] reported a loss of residual hearing in roughly half of 40 implanted patients.…”

“…Some reports suggest that the use of a short electrode or one from the standard electrode array will result in the preservation of residual hearing [10,11]; other studies suggest it is not possible to conserve residual hearing using a long (114 mm) electrode [9,11]. Further suggestions for preserving residual hearing refer to the use of soft surgery approach [12,14].…”